In September 2023, I highlighted the campaign by Merope Mills for the NHS to enact Martha’s Rule, which would empower a family to request a second clinical opinion from a more senior doctor within the hospital, where there was concern over a suspected deterioration in their loved one.

Following extensive campaigning by Merope and her family, the then Health Secretary announced it would implement the initiative, with the 3 main components of Martha’s Rule set out as follows:

1. Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.

2. All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.

3. This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.

In May 2024 NHS England announced that 143 healthcare sites across the country would implement this process, the aim being of course to avoid the tragic consequences that Martha’s family faced when she sadly died.

Recently, the Sunday Times analysed just how the implementation has been received and whether it has produced measurable change. It highlights that available data from September 2024 to February 2025, demonstrates that 129 patients following the Martha's Rule review (the scheme does not yet operate in Wales) received lifesaving medical interventions with 57 being moved to a high dependency or intensive care unit.

Furthermore of all the calls made in the first 6 months of the scheme, 1 in 5 resulted in differing care being administered such as alternative medication or life saving urgent intervention.

For Martha’s family, this tragically of course comes too late, but where there has been such a change implemented to make a tangible difference to a person’s well being, or indeed survival, this has to be a welcome amendment to ensuring the preservation of patient safety.

What seems the obvious message is that in some instances of care being provided, families, patients, or their loved ones are not being listened to.

In its simplest form, that is the essence of the Rule – listen. I have sat in countless conferences with doctors, surgeons and healthcare professionals where it’s often being commented “the assessing doctor didn’t take a history”, or “they didn’t ask the right questions” or “they just didn’t listen to the patient”.

Whilst the NHS operates under tremendous pressure with finite resources, that particular skill - listening – comes at no cost.